Embed Size (px)
Citation preview
SMALL AREA HEALTH INSURANCE ESTIMATES (SAHIE)
SHADAC Webinar Featuring U.S. Census Bureau ExpertsJune 9, 2016, 12:00 -12:30 PM EDT
You will be connected to broadcast audio through your computer. You can also connect via telephone: (866)-831-1467, Conference ID 17495609Slides and handouts at: www.shadac.org/2016SAHIEwebinar
Technical Items
• For those dialing in: Phones automatically muted
• Submit questions using the chat window at any time during the webinar
• Problems:• Call Readytalk’s help line: (800) 843-9166• Ask for help using the chat feature
• Download the slides at www.shadac.org/2016SAHIEwebinar
• Webinar archive will be posted on SHADAC’s website• E-mail notice will be sent to participants
2
Presenters
3
David PowersU.S. Census Bureau
Joanna TurnerSHADAC
Brett FriedSHADAC
Lauren BowersU.S. Census Bureau
4
Small Area Health Insurance Estimates from the Census Bureau: 2013 and 2014
David Powers and Lauren BowersSocial, Economic, and Housing Statistics DivisionUnited States Census Bureau
Presentation for State Health Access Data Assistance Center (SHADAC)June 9, 2016
Disclaimer: This presentation is released to inform interested parties of ongoing research and to encourage discussion. Any views expressed are those of the authors and not necessarily those of the U.S. Census Bureau.
5
Small Area Health Insurance Estimates (SAHIE)
• Model-based health insurance coverage estimates
• Only source of single-year health insurance coverage estimates for all U.S. counties
• Recently released estimates• 2014 SAHIE• Updated version of 2013 SAHIE
• Release highlights• Incorporated new up-to-date
Medicaid source data • Substantial 2013 to 2014 changes
in health insurance in many areas
6
• SAHIE is partially funded by the Centers for Disease Control and Prevention’s (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP)
• The CDC uses SAHIE to assess the eligible population of low-income, uninsured women for cancer screening and diagnostic services under the NBCCEDP
Sponsor: Centers for Disease Control and Prevention (CDC)
7
SAHIE Cross ClassificationsAge Sex Income Race and Ethnicity
(State only) Under age 65 18 to 64 years40 to 64 years50 to 64 yearsUnder age 19*
Both SexesMaleFemale
All IncomesAt or below 200% of poverty At or below 250% of povertyAt or below 138% of poverty At or below 400% of povertyBetween 138 and 400% of poverty
All Race and EthnicitiesWhite Alone, not HispanicBlack Alone, not HispanicHispanic
*For the population under age 19 estimates are not available by sex or by race and ethnicity
By “% of poverty,” we mean the ratio of income to the federal poverty threshold
8
SAHIE Cross ClassificationsAge Sex Income Race and Ethnicity
(State only) Under age 65 18 to 64 years40 to 64 years50 to 64 yearsUnder age 19*
Both SexesMaleFemale
All IncomesAt or below 200% of poverty At or below 250% of povertyAt or below 138% of poverty At or below 400% of povertyBetween 138 and 400% of poverty
All Race and EthnicitiesWhite Alone, not HispanicBlack Alone, not HispanicHispanic
*For the population under age 19 estimates are not available by sex or by race and ethnicity
Centers for Disease Control
(CDC)
Children’s Health Insurance Program
(CHIP)
Patient Protection and Affordable Care Act
(ACA)
By “% of poverty,” we mean the ratio of income to the federal poverty threshold
9
When to Use SAHIE?U.S. Census Bureau Health Insurance Data Source Recommendations
Available on the web: http://www.census.gov/hhes/www/hlthins/about/index.html
10
SAHIE Data Sources• American Community Survey (1-year and 5-year)• Census 2010 (housing tenure, % rural tabulations)• Population estimates• County Business Patterns
• Aggregated federal 1040 tax returns
• Supplemental Nutrition Assistance Program (SNAP) participation records
• Medicaid participation records • Children's Health Insurance Program (CHIP)
participation records
12
Benefits from Modeling
• Estimates can be released for all counties, regardless of population size, and for many detailed domains
• Reduction in year-to-year volatility relative to the survey estimates
• Improvement in precision (margins of error) relative to the survey estimates
13
Model Estimate
ACS Estimate
Weighted average between survey estimate and model estimateHow the SAHIE Models Work
14
15
16
• American Community Survey (1-year and 5-year)• Census 2010 (housing tenure, % rural tabulations)• Population estimates• County Business Patterns
SAHIE Data Sources
• Aggregated federal 1040 tax returns
• Supplemental Nutrition Assistance Program (SNAP) participation records
• Medicaid participation records • Children's Health Insurance Program (CHIP)
participation records
18
• Starting in late 2013, CMS began to release new timely Medicaid/CHIP summary data
• SAHIE historically has used Medicaid/CHIP participation data that lagged 2 years behind the estimate year• e.g., 2012 SAHIE used 2010 Medicaid and CHIP data
• Opportunity for SAHIE to improve source data timeliness and to protect against uncertain delays in future delivery
• Using more up-to-date Medicaid/CHIP data may be especially important during 2013-2014 as many states expanded Medicaid eligibility under the ACA
New Medicaid Data (1)
19
• SAHIE production now incorporates the new CMS Medicaid/CHIP summary data together with the previous (detailed but lagged) Medicaid/CHIP data
• The resulting SAHIE, which uses the combined new Medicaid/CHIP data, show improved consistency with ACS 1-year estimates of the uninsured for people aged 0-18 in smaller counties
New Medicaid Data (2)
For more information on SAHIE’s use of updated Medicaid enrollment data, please visit http://www.census.gov/did/www/sahie/methods/inputs/medicaid.html
20
2013-2014 Changes in Uninsured Rates• Decreases in uninsured rates
occurred in 74.1 percent of U.S. counties for the population under age 65
• Were largely driven by the decreases for the working-age adult (aged 18-64) population
• Were more prominent in states that expanded their Medicaid eligibility criteria
SAHIE Highlights and figures are available at: http://www.census.gov/did/www/sahie/ data/highlights/2014.html
21U.S. Department of Commerce Economic and Statistics Administration U.S. CENSUS BUREAU
Health Insurance Coverage Estimates
MODEL-BASED ESTIMATES
2013 Uninsured Rate Population Under Age 65
Source: U.S. Census Bureau, 2013 Small Area Health Insurance
Estimates (SAHIE)
The data provided are indirect estimatesproduced by statistical model-basedmethods using sample survey, decennialcensus, and administrative data sources.The estimates contain error stemming frommodel error, sampling error, andnonsampling error.
The data provided are indirect estimatesproduced by statistical model-basedmethods using sample survey, decennialcensus, and administrative data sources.The estimates contain error stemming frommodel error, sampling error, andnonsampling error.
MODEL-BASED ESTIMATES
MODEL-BASED ESTIMATES
Percent Uninsuredby Countyin 2014
25.1 and Above20.1 to 25.015.1 to 20.010.1 to 15.010.0 and Below State
Percent Uninsured: 2013 and 2014
2014 Uninsured Rate Population Under Age 65
Percent Uninsured by Countyin 2013
25.1 and Above20.1 to 25.015.1 to 20.010.1 to 15.010.0 and Below State
Source: U.S. Census Bureau, 2014 Small Area Health Insurance
Estimates (SAHIE)
22
23
24
25
2014 Release Products
26
• Press Release
2014 Release Products
27
• Press Release• Census Bureau’s API
2014 Release Products
28
• Press Release• Census Bureau’s API• Research Matters blog
2014 Release Products
29
• Press Release• Census Bureau’s API• Research Matters blog• Conference papers
2014 Release Products
30
• Press Release• Census Bureau’s API• Research Matters blog• Conference papers• SAHIE website:
‒ Data for downloado .CSV, .TXT files
‒ Interactive tool
2014 Release Products
31
• Press Release• Census Bureau’s API• Research Matters blog• Conference papers• SAHIE website:
‒ Data for downloado .CSV, .TXT files
‒ Interactive tool ‒ Updated 2013 SAHIE and comparison tab of original vs.
new
2014 Release Products
32
• Press Release• Census Bureau’s API• Research Matters blog• Conference papers• SAHIE website:
‒ Data for downloado .CSV, .TXT files
‒ Interactive tool ‒ Updated 2013 SAHIE and comparison tab of original vs. new‒ Highlights document
2014 Release Products
33
• Press Release• Census Bureau’s API• Research Matters blog• Conference papers• SAHIE website:
‒ Data for downloado .CSV, .TXT files
‒ Interactive tool ‒ Updated 2013 SAHIE and comparison tab of original vs. new‒ Highlights document‒ Heat map for 2005 through 2014
2014 Release Products
34
Contact Information
Lauren [email protected]
301-763-1135
Small Area Estimates BranchSocial, Economic, and Housing Statistics Division
http://www.census.gov/did/www/sahie/
David [email protected]
301-763-5892
35
SAHIE Website: http://www.census.gov/did/www/sahie/index.htmlData for download:Data interactive tool (table , maps , and trend tools)http://www.census.gov/did/www/sahie/data/interactive/sahie.htmlCSV and text fileshttp://www.census.gov/did/www/sahie/data/20082014/index.htmlCensus Bureau’s APIhttp://www.census.gov/data/developers/data-sets/Health-Insurance-Statistics.html
Reports and Graphics:Press Releasehttp://www.census.gov/newsroom/press-releases/2016/cb16-86.html2014 SAHIE Release Highlightshttp://www.census.gov/did/www/sahie/data/2014/2014highlights.pdf2014 SAHIE Maps http://www.census.gov/did/www/sahie/data/highlights/2014highlights.htmlHeat Maphttp://www.census.gov/did/www/sahie/data/visualization/healthins/index.html?reload
Conference papers:Medicaid and CHIP Data Methodology for SAHIE Models - David Powers, Lauren Bowers, Wesley Basel, and Samuel Szelepka http://www.census.gov/content/dam/Census/library/working-papers/2016/demo/powers-bowers-basel-szelepka-fcsm.pdfEvaluating 2012-2014 Trends in Health Insurance Coverage for All U.S. Counties - Lauren Bowers, Wes Basel, and David Powershttp://www.census.gov/content/dam/Census/library/working-papers/2016/demo/SEHSD-WP2016-16.pdf
Blogs:More Timely Medicaid Data Helps Improve Small Area Health Insurance Estimateshttp://researchmatters.blogs.census.gov/2016/05/12/more-timely-medicaid-data-helps-improve-small-area-health-insurance-estimates/Evaluating 2013-2014 Trends in County-Level Health Insurance Coverage for Low-Income Working-Age Adults http://researchmatters.blogs.census.gov/2016/04/02/evaluating-2013-2014-tr, ends-in-county-level-health-insurance-coverage-for-low-income-working-age-adults/
Reference Page
One example of how SHADAC uses the SAHIE estimates
36
